02/19/2020 03:15 PM LABOR & COMMERCE

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HB 91-NATUROPATHS: LICENSING; PRACTICE3:20:02 PM
CHAIR SPOHNHOLZ announced that the first order of business would
be HOUSE BILL NO. 91, "An Act relating to the practice of
naturopathy; relating to the licensure of naturopaths; relating
to the Department of Commerce, Community, and Economic
Development; and providing for an effective date."
3:20:19 PM
REPRESENTATIVE STUTES moved to adopt the proposed committee
substitute (CS) for HB 91, labeled 31-LS0608\K, Fisher, 2/8/20,
as the working draft.
3:20:38 PM
CHAIR SPOHNHOLZ objected for the purpose of discussion.
3:20:46 PM
ERIN SHINE, Staff, Representative Jennifer Johnston, Alaska
State Legislature, on behalf of Representative Johnston, prime
sponsor, explained the changes to HB 91 proposed under Version
K, which replaces Version M. She paraphrased from a document
provided in the committee packet, entitled "House Bill 91 ver. K
Explanation of Changes," which read as follows [original
punctuation provided]:
Section 2 Adds a five-person Naturopathy Advisory
Board for the purpose of making recommendations on
adoption of regulations and other department matters
relating to naturopaths
Sections 3-7, 10-15, 18 Adds and amends sections to
provide the Department of Commerce, Community and
Economic Development's Division of Corporations,
Business and Professional Licensing appropriate powers
and oversight of naturopathic doctors for licensing,
investigations, and disciplinary actions
Section 8 Adds a provision that requires
naturopathic doctors to pass the Naturopathic
Physicians Licensing Examination pharmacology portion
to be able to prescribe allowed medications
Section 10 Amends to increase the public health
duties to report for naturopathic doctors to mirror
the requirements for other health care providers
Section 14 Adds requirement for the department to
report actions on naturopathic licensees to the
National Practitioner Data Bank
Section 15 Adds title protection for naturopath
Section 22 Updates the effective date to January 1,
2021
3:23:54 PM
The committee took a brief at-ease.
3:23:59 PM
REPRESENTATIVE STORY asked if Version K narrows the scope of
prescriptive ability for naturopathic doctors (NDs).
MS. SHINE offered her belief that it does not. She said they
envisioned the same prohibitions in Version K as in the previous
CS, which prohibits naturopaths from prescribing controlled
substances and chemotherapeutic agents.
3:25:19 PM
REPRESENTATIVE STORY, referring to Section 8 of Version K, said
the addition of a provision that requires naturopathic doctors
to pass an exam seems to narrow their scope of practice further.
MS. SHINE noted that their prescriptive abilities remain the
same; however, naturopathic doctors would have to pass the
pharmacology portion of the Naturopathic Physicians Licensing
Examination to be able to prescribe in Alaska.
3:25:54 PM
REPRESENTATIVE STUTES directed attention to the fiscal note
[identifier: HB091-DCCED-CBPL-01-16-20] and asked how it's $0
when there's an advisory board.
MS. SHINE offered her understanding that the previous CS had
$4,200 appropriated for adopting regulations. She explained
that if Version K were to move from committee, the division
director would probably update the fiscal note to reflect the
costs. She noted that this wouldn't be spent from general funds
because the licensing professions bear their own costs in their
licensing fees.
3:26:55 PM
CHAIR SPOHNHOLZ removed her objection. There being no further
objection, Version K was adopted as the working draft.
3:27:55 PM
SUZETTE MAILLOUX, Alaska Association of Naturopathic Physicians,
provided a brief personal background. She said Alaska is
missing out on many qualified, capable [naturopathic] doctors
who don't want to accept the state's limited scope of practice.
She pointed out that naturopaths are trained as primary care
physicians and offered her belief that the limited scope of
practice is a waste of their training. She reflected on her
personal experience with the inability to prescribe to her
patients, which forces them to see other providers - costing
them more time and money. She said the reality of medicine is
that prescriptions and minor office procedures are often
necessary. She touted the safety record that NDs have in both
Alaska and in states that allow for a full scope of practice.
She reiterated that they are fully trained as physicians and
want to stay in Alaska to provide safe an effective care. To
conclude, she addressed opposing testimony consisting of
malpractice claims that she said are unsubstantiated and were
never reported to the state.
3:31:38 PM
REPRESENTATIVE STORY questioned whether Ms. Mailloux took
pharmacology classes that would allow her to prescribe.
MS. MAILLOUX answered yes, adding that she received her training
in Oregon where, had she stayed and pursued licensure, she would
have the full scope of practice of a primary care physician.
She further noted that the addition of Section 8 in the current
CS would ensure that naturopathic doctors stay up to date with
current pharmacological knowledge and training.
3:32:53 PM
REPRESENTATIVE STUTES asked if there are residencies involved in
a naturopath's education.
MS. MAILLOUX replied that residencies are not required for
naturopathic doctors, they are optional. She noted that there
are not enough residency positions for NDs in the U.S., as they
do not practice hospital-based medicine.
3:33:47 PM
REPRESENTATIVE FIELDS sought to clarify which surgeries
naturopaths would be allowed do under HB 91. He directed
attention to Section 8, paragraph (3), which read as follows:
perform procedures in the office using operative,
electrical, or other methods, including the use of
antiseptics and local anesthetics, for the surgical
repair and care of superficial lacerations, abrasions,
and lesions and the removal of foreign bodies located
in the superficial tissues of the human body; the
procedures may not include general or spinal
anesthetics, major surgery, surgery of the body
cavities, plastic surgery, surgery involving the eyes,
or surgery involving tendons, ligaments, nerves, or
blood vessels; and
3:34:27 PM
MS. MAILLOUX, in response to Representative Fields, listed small
biopsies, mole removals, stitches of minor cuts, and IUD
[intrauterine device] placement and removal.
3:35:01 PM
REPRESENTATIVE FIELDS asked how naturopaths and medical doctors
differ in the dermatological training they receive.
MS. MAILLOUX said it's similar; however, they differ in the
variety of treatments offered, as well as the philosophy of
medicine. Regarding the basic science, pathology, or assessing
for illness - both are "on par."
3:35:57 PM
CHAIR SPOHNHOLZ announced that HB 91 was held over.